Background: Chronic hypertension (HTN) leads to variouspathophysiological and hemodynamic changes that ultimately culminates into left ventricular hypertrophy (LVH) and heart failure. Two­dimensional speckle tracking echocardiography (2D­STE) is novel technique that allows rapid and accurate analysis of incipient stages of systolic and diastolic left ventricular(LV) dysfunction.

Objective: The objective of this study was to assess the ability of 2D­STE in the assessment regional and global LV strains to characterize features of subclinical LV dysfunction in patients withsystemic hypertension and relatively preserved ejection fraction (EF).

Material and Methods: Two­dimensional echocardiographic (2DE) images of the LV were acquired in apical four­chamber and parasternal short­axis at the basal levels in 60 subjects, including 15 healthy controls and 45 patients with systemic hypertension. Longitudinal strain (LS) and circumferential strain (CS) were quantified in 13­segment model using Philips IE­33 x matrix machine.

Results: In comparison with normal controls, global longitudinal LV systolic strain (LVGLS) and global circumferential LV systolic strain (LVGCS) was significantly attenuated in the patients with chronic systemic hypertension. Regional strain in longitudinal axis was significantly reduced at Apex(Ap) and Apicolateral (Apl) and Mid inferior septum (MIS) segment of LVin hypertensive population compared to normotensive group while the regional strain in circumferential axiswas significantly reduced at all six segments (basal anterior, basal anterior septum, basal inferior septum, basal inferior, basal inferior lateral wall and mid anterolateralwall). Strain rate (SR) values were insignificantly reduced in both hypertensive groups with and without LVH in early diastole (at peak E).

Conclusion: 2D­STE detected substantial impairment of LV strain and regional deformation in chronic hypertensive patients with apparently preserved LVEF, which identifies higher risk subgroups for earlier pharmacolgical intervention in patients with HTN.